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T-wave alternans

beat to beat variability in the shape of EKG T-waves Laboratory: - see microvolt T-wave alternans testing Clinical significance: - reflects heterogeneity in ventricular repolarization, a mechanism of re-entry arrhythmias [1,2] - lack of T-wave alternans identifies patients with ischemic heart disease or non-ischemic cardiomyopathy at low risk for sudden cardiac death - presence does not identify patients at high risk [3,4]

Related

microvolt T-wave alternans microvolt testing (MTWA)

General

sign/symptom

References

  1. Smith JM et al. Electrial alternans and cardiac electrical instability Circulation 1988, 77110 PMID: 3335062
  2. Rosenbaum DS et al, Electrical alternans and vulnerability to ventricular arrhythmias. N Engl J Med 1004, 330:235 PMID: 8272084
  3. Narayan SM, T-wave alternans and the susceptibility to ventricular arrhythmias. J Am Coll Cardiol 2006, 47:269 PMID: 16412847
  4. Salerno-Uriarte et al, Prognostic value of T-wave alternans in patients with heart failure due to nonischemic cardiomyopathy: Results of the ALPHA study. J Am Coll Cardiol 2007, 50:1896 PMID: 17980258
  5. Wikipedia: T wave alternans http://en.wikipedia.org/wiki/T_wave_alternans